Provider Demographics
NPI:1922261429
Name:KARE THERAPEUTICS PT PC
Entity Type:Organization
Organization Name:KARE THERAPEUTICS PT PC
Other - Org Name:LIFE STRENGTH PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIECO
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:631-724-5433
Mailing Address - Street 1:267 SMITHTOWN BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:NESCONSET
Mailing Address - State:NY
Mailing Address - Zip Code:11767-2120
Mailing Address - Country:US
Mailing Address - Phone:631-724-5433
Mailing Address - Fax:631-724-5478
Practice Address - Street 1:267 SMITHTOWN BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:NESCONSET
Practice Address - State:NY
Practice Address - Zip Code:11767-2120
Practice Address - Country:US
Practice Address - Phone:631-724-5433
Practice Address - Fax:631-724-5478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-03
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017650 1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100000955Medicare PIN